A digest of events, trends, issues, ideas and journalism from and about rural America, by the Institute for Rural Journalism and Community Issues, based at the University of Kentucky.
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Tuesday, December 19, 2017

Lawmakers say they will fund CHIP but haven't agreed how; Ala. to stop enrollment if they don't

As one state warned that it would stop enrolling kids in the Children's Health Insurance Program on Jan. 1 for lack of funds, Senate Republicans said an extension of the program would be in this week's must-pass bill to keep the federal government running. But Senate and House negotiators still haven't agreed on the details, and "Who will blink and when could determine the future of the program," Alice Ollstein reports for Talking Points Memo. The program covers nearly 9 million low- and mid-income children whose parents can't afford private health insurance, but who make too much money to qualify for Medicaid. Republicans want states to assume an increasing amount of the cost of the program, if not all, eventually.

Senate Majority Whip John Cornyn of Texas said last week that Congress would pass a long-term CHIP bill this week, Jessie Hellman reports for The Hill. Majority Leader Mitch McConnell announced Monday that the CHIP extension would be included in the stopgap spending bill. However, "Senate Democrats are threatening to oppose House Republicans’ version that cuts public health programs
to pay for CHIP, noting that they aren’t demanding similar offsets for
either the $1.4 trillion tax bill or $81 billion disaster aid bill up
for votes this week," TPM reports. Hellman notes, "Because Republicans have such a slim majority in the Senate, Democratic support is needed for the bill."

Meanwhile, Alabama has become the first state to announce that it would freeze CHIP enrollment Jan. 1 and close the program Jan. 31 if federal funding is not restored soon. Virginia and Colorado have sent out letters telling beneficiaries that their coverage is at risk. Both states have allowed children to keep enrolling up until the termination date, Quinn Libson reports for Route Fifty. All states' CHIP funding lapsed on Sept. 30, but they have been using leftover funds, redistributed by the Centers for Medicare and Medicaid Services. Connecticut and Colorado have said they will also shut down their programs Jan. 31 if funding doesn't come through and will shift CHIP kids to Medicaid or private insurance from an Obamacare exchange. Most state would run out by March, and all 50 states and the District of Columbia would run out by June.

A Politico map shows when each state is expected to run out of money; click the image to enlarge it.

If Alabama freezes enrollment in its CHIP program, it won't be the first time a state has done so. Arizona did it in 2009 during the
recession, in what researchers from Georgetown University's Center for Children and Families call a "cautionary tale." It saved the state $12.9 million in fiscal year 2011, but there were down sides: 14,000 children lost medical coverage completely, and "by July 2011, the waiting list for that program had swelled to include
more than 100,000 kids. According to the Kaiser Family Foundation, the
waiting list continued to grow at a rate of 10,000 kids every month." The state also lost $41 million in federal matching funds.

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This blog generally follows traditional journalistic standards. It's not about opinions, though you may read one here occasionally. It's about facts that we think will be useful to rural journalists, non-rural journalists who do rural stories, and others interested in rural issues. We don't try to be provocative, so we don't generate as many comments as most blogs with the level of traffic we have, but we certainly invite comments -- and contributions, to al.cross@uky.edu. Feel free to republish blog items, with credit to us and the original source.